National Provider Identifier [NPI]: |
1780981159 |
Last Name Of The Provider |
BODINE |
First Name Of The Provider |
NICOLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
ARNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3620 GULF SHORES PKWY |
Street Address 2 Of The Provider |
SUITE 230 |
City Of The Provider |
GULF SHORES |
Zip Code Of The Provider |
365422847 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
1541 |
Number Of Medicare Beneficiaries |
404 |
Total Submitted Charge Amount |
110575.05 |
Total Medicare Allowed Amount |
71621.7 |
Total Medicare Payment Amount |
49084.62 |
Total Medicare Standardized Payment Amount |
64130.93 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
206 |
Number Of Medicare Beneficiaries With Drug Services |
47 |
Total Drug Submitted ChargeAmount |
2113.5 |
Total Drug Medicare AllowedAmount |
140.58 |
Total Drug Medicare PaymentAmount |
66.88 |
Total Drug Medicare Standardized Payment Amount |
66.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
1335 |
Number Of Medicare Beneficiaries With Medical Services |
404 |
Total Medical Submitted Charge Amount |
108461.55 |
Total Medical Medicare Allowed Amount |
71481.12 |
Total Medical Medicare Payment Amount |
49017.74 |
Total Medical Medicare Standardized Payment Amount |
64064.05 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
52 |
Number Of Beneficiaries Age 65 to 74 |
205 |
Number Of Beneficiaries Age 75 to 84 |
114 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
385 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8789 |